“Digital is nice, but only to smart people”: a qualitative analysis of barriers to digital healthcare for Nepali migrants in Finland

Abstract Background The rapid digitalisation of healthcare has been promoted globally to enhance efficiency, transparency, and self-management, with high-income countries adopting “digital-first” approaches. In Finland, platforms such as MyKanta and Maisa exemplify this strategy. While these initiatives aim to expand access, research shows that digital healthcare can also exacerbate inequalities, particularly for migrants. Existing studies have largely focused on larger migrant communities, leaving the experiences of diverse migrant groups understudied. This study addresses the gap by examining the digital healthcare experiences of Nepali migrants in Finland, with a focus on the challenges they face and the implications for equitable and culturally responsive care. Results Interviews with 27 Nepali migrants revealed multiple barriers to using digital healthcare. Limited digital skills restricted engagement with online platforms, creating a divide between digitally competent users and those excluded. Language barriers, particularly the dominance of Finnish, compelled participants to rely on translation tools or costly private services with English interfaces, reinforcing inequities. Reliance on proxy users, including family members and children, was widespread. While this reflected cultural norm of shared responsibility and offered practical support, it also reduced autonomy and raised privacy risks that could extend to financial and other official matters. In-person care was commonly perceived as more trustworthy, comprehensible, and emotionally supportive than digital alternatives. Gestures, physical presence, and respect for doctors were viewed as integral to effective communication and healing. These findings highlight a mismatch between Finland’s highly digitalised healthcare system and migrants’ lived realities, with digitalisation often experienced as inevitable rather than a personal choice. Conclusions The study demonstrates that access to digital healthcare among migrants is shaped more by structural and policy-level factors than by individual shortcomings. Possession of smartphones and internet access did not guarantee meaningful engagement, as skills, language, and cultural expectations created systemic barriers. Addressing these challenges requires multilingual, user-friendly platforms, digital training tailored for migrant groups, and hybrid service models that preserve in-person care. Without such measures, digitalisation risks deepening rather than reducing healthcare inequalities, undermining the goal of universal health coverage.